Current Urology Reports最新文献

{"title":"Intravesical Recurrence of Upper Tract Urothelial Carcinoma: Strategies for Prevention.","authors":"Lingmin Song, Margaret Meagher, Ava Saidian, Amirali Salmasi, Sarah Azari, Mai Dabbas, Aditya Bagrodia","doi":"10.1007/s11934-026-01331-6","DOIUrl":"10.1007/s11934-026-01331-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review focuses on intravesical recurrence (IVR) of upper tract urothelial carcinoma (UTUC).</p><p><strong>Recent findings: </strong>We explore epidemiology, risk factors, mechanisms of tumor cell seeding, molecular pathways, genetic predispositions, and related factors of UTUC. Diagnostic techniques, strategies managing disease and reducing recurrence, as well as controversies and challenges in UTUC management are discussed. By synthesizing the latest research findings, this review aims to provide a comprehensive understanding of UTUC IVR which can guide clinical practice and future research efforts.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"27 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13468967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Big Data Analytics in Urologic Oncology: A Comprehensive Review of Large-scale Database Research and Clinical Applications.","authors":"Ali Bourgi, Emmanuel Rusch, Pierre Bigot, Franck Bruyère","doi":"10.1007/s11934-026-01351-2","DOIUrl":"10.1007/s11934-026-01351-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Large-scale databases have become an essential resource in urologic oncology, enabling the generation of real-world evidence across broad and diverse patient populations. This narrative review aims to summarize the contribution of population-based cancer registries, hospital-based clinical registries, and administrative healthcare databases to the understanding and management of prostate, bladder, renal, and other genitourinary malignancies.</p><p><strong>Recent findings: </strong>Over the past decade, large database studies have provided key insights into cancer epidemiology, treatment patterns, outcomes, and healthcare disparities. These data sources complement randomized clinical trials by capturing routine clinical practice at a population level. Major findings include shifts in cancer incidence and mortality, increased adoption of active surveillance in low-risk prostate cancer, and greater use of nephron-sparing approaches in renal cell carcinoma. In addition, large-scale analyses have highlighted disparities related to patient demographics, institutional volume, and access to care. They have also contributed to evaluating the real-world effectiveness and safety of established therapies, particularly in populations often underrepresented in clinical trials. Despite their strengths-particularly large sample sizes and enhanced generalizability-big data studies remain subject to important limitations, including residual confounding, coding variability, and limited availability of granular clinical and biological information. When interpreted with appropriate methodological rigor, these observational data provide valuable evidence to support clinical decision-making, inform guideline development, and identify gaps in care. Continued improvements in data quality, analytical methods, and integration with emerging technologies are expected to further strengthen the role of real-world data in advancing urologic oncology.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"27 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostatic Artery Embolization: A Contemporary Review of Efficacy, Safety, and Expanding Clinical Indications.","authors":"George Tawfellos, Cristofer Zillo, Fabian Laage Gaupp, Ganesh Sanekommu","doi":"10.1007/s11934-026-01352-1","DOIUrl":"10.1007/s11934-026-01352-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>Prostatic artery embolization (PAE) has emerged as a minimally invasive treatment for a spectrum of prostatic conditions. Supported by a growing body of randomized and observational evidence, PAE now occupies an established role in the management of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) and is increasingly applied for refractory prostatic bleeding and hematospermia. A structured review of PubMed, Google Scholar, and MEDLINE was performed with priority given to studies published from 2020 onward, including randomized controlled trials, prospective multicenter studies, large observational cohorts, and current guideline statements. Outcomes of interest included technical success, symptom improvement, urodynamic parameters, postvoid residual volume, hematuria resolution, retreatment rates, and adverse events.</p><p><strong>Recent findings: </strong>For BPH-related LUTS, PAE produces meaningful and durable symptom improvement. However, it consistently demonstrates inferior urodynamic outcomes and higher long-term retreatment rates compared with transurethral resection of the prostate (TURP) and holmium laser enucleation. PAE's advantages include lower periprocedural risk in medically high risk patients and early preservation of sexual and continence-related function. For refractory prostatic bleeding - including BPH-related, malignant, and post-procedural etiologies - retrospective and prospective series consistently report high technical success and clinically meaningful hemostasis, supporting its use in patients who are poor surgical candidates or who have failed transurethral surgery. Evidence for PAE in refractory hematospermia is limited to small case series and remains investigational. PAE is a safe, guideline-recognized treatment option for BPH that offers meaningful symptom relief with a favorable safety profile, though with less durable outcomes than transurethral surgery. It serves as a clinically valuable salvage or palliative option for refractory prostatic bleeding. Patient selection, shared decision-making with urology and interventional radiology, and realistic counseling about durability are essential to optimizing outcomes.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"27 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Management of PSMA PET-Positive Lymph Nodes in Prostate Cancer.","authors":"Andrea Cosenza, Leonardo Quarta, Armando Galdieri, Michele Brancaccio, Angelo Occhi, Maria Elena Porzi, Paolo Zaurito, Alessandro Viti, Alfonso Santangelo, Pietro Scilipoti, Simone Scuderi, Francesco Barletta, Armando Stabile, Francesco Montorsi, Alberto Briganti, Giorgio Gandaglia","doi":"10.1007/s11934-026-01348-x","DOIUrl":"10.1007/s11934-026-01348-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>PSMA PET has reshaped prostate cancer staging by detecting low-volume nodal metastases occult on conventional imaging. This review summarizes current evidence on miN1M0 disease and discusses features that may guide surgical decision-making.</p><p><strong>Recent findings: </strong>Evidence remains heterogeneous, and the role of surgery in miN1M0 disease is undefined. Contemporary series suggest that surgery may be feasible within multimodal treatment in selected patients, supporting that miN1M0 disease should not automatically preclude surgery. Surgical candidacy should consider nodal burden and location, local tumor extent, tumor biology, and technical resectability. Low-volume pelvic nodal disease may represent the most plausible surgical scenario, whereas multiple positive nodes, extra-pelvic involvement, locally advanced disease, and adverse biology suggest higher systemic risk. miN1 status should trigger individualized selection rather than surgical exclusion. Prospective studies are needed to clarify which patients may benefit from surgery within multimodal care.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"27 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise and Physical Activity as Modifiable Risk Factors for Benign Prostatic Hyperplasia: An Update.","authors":"Frederico Branco, Sílvia Rocha-Rodrigues, María J Ribal, Ricardo Ribeiro","doi":"10.1007/s11934-026-01346-z","DOIUrl":"10.1007/s11934-026-01346-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Benign prostatic hyperplasia (BPH) is a highly prevalent urological condition in aging men, contributing to lower urinary tract symptoms (LUTS) and reducing the quality of life. The increasing burden of BPH underscores the need for preventive strategies targeting modifiable risk factors. This review examines the evidence on the association between physical activity (PA), exercise, and BPH risk, aiming to determine whether these two forms of activity exert different effects on BPH pathogenesis.</p><p><strong>Recent findings: </strong>A literature search was conducted in multiple databases to identify human studies evaluating the association between PA or exercise and the risk of developing BPH and/or LUTS. A total of 19 studies were included: 17 observational studies, one meta-analysis, and one two-sample Mendelian randomization study. Among the six studies evaluating exercise, four reported a protective effect against BPH development, while two found no significant association. Moderate-intensity exercise appeared to confer greater protection than high-intensity exercise. Of the 14 studies assessing PA, seven reported a protective effect, with most indicating that high-intensity PA provided the greatest benefit. Two studies yielded mixed results, while five found no significant association between PA and BPH risk. Although moderate-intensity exercise and moderate-to-high PA appear to reduce BPH risk, evidence remains inconsistent. Future research should prioritize randomized controlled trials with standardized protocols, clearly defined outcomes, and objective assessment of dose-response effects to elucidate underlying mechanisms. Such approaches are critical to clarify the role of exercise and PA in BPH prevention and to inform clinical and public health recommendations.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"27 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstructive Sleep Apnea Syndrome and Overactive Bladder: Expanding the Perspective to Women-A Narrative Review.","authors":"Elif Balevi Batur, Ali Furkan Batur","doi":"10.1007/s11934-026-01347-y","DOIUrl":"10.1007/s11934-026-01347-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>Obstructive sleep apnea syndrome (OSAS) is increasingly recognized as a multisystem disorder with important effects on the lower urinary tract, including overactive bladder (OAB). Although the association between OSAS and OAB has been widely investigated, most available evidence originates from male populations, whereas women remain underrepresented despite distinct hormonal, anatomical, and pelvic floor characteristics. Unlike previous reviews that primarily focused on OSAS and nocturia or predominantly male populations, this review specifically highlights female-related pathophysiological mechanisms, emerging clinical evidence, and their potential implications for the evaluation of women with OAB.</p><p><strong>Recent findings: </strong>Recent evidence supports a significant association between OSAS and OAB through multiple interacting mechanisms, including intermittent hypoxia, autonomic nervous system dysregulation, increased atrial natriuretic peptide secretion, circadian rhythm disruption, systemic inflammation, and oxidative stress. Emerging studies suggest that female-specific factors such as menopause, estrogen deficiency, and pelvic floor dysfunction may further amplify bladder symptoms. In addition, treatment of OSAS, particularly with continuous positive airway pressure, has been associated with improvement in OAB symptoms, supporting a potentially modifiable relationship. Current evidence demonstrates a consistent association between OSAS and OAB, although a causal relationship has not yet been established. Recognition of OSAS as a potential contributing factor, particularly in women with refractory OAB or prominent nocturia, may improve clinical evaluation and support a more comprehensive multidisciplinary approach. Further prospective studies focusing on female populations are needed to clarify causal mechanisms and determine which patients are most likely to benefit from targeted screening.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"27 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single Port Robotic Surgery in Benign Urologic Disease - A Review of Contemporary Applications and Outcomes.","authors":"Matthew J Rabinowitz, Angeline Johny, Phillip Mucksavage","doi":"10.1007/s11934-026-01345-0","DOIUrl":"10.1007/s11934-026-01345-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>The advent of the Intuitive da Vinci single-port (SP) robotic system represents a pivotal evolution in minimally invasive urologic surgery, offering enhanced dexterity, improved surgical ergonomics, and reduced patient morbidity. This review is designed to provide a comprehensive evaluation of current literature regarding the feasibility, efficacy, cost considerations, and clinical applications of the SP platform across various benign urologic surgeries including pyeloplasty, ureteral reconstruction, donor nephrectomy, renal auto-transplantation, partial cystectomy, and simple prostatectomy. The review also analyzes current limitations of the robotic platform including a narrower range of available instruments, diminished instrument grip strength, and a steeper learning curve.</p><p><strong>Recent findings: </strong>Across these procedures, the SP system demonstrates comparable operative outcomes when compared to multi-port (MP) and open approaches. The SP system also has notable advantages in postoperative analgesia, incisional cosmesis, and hospital length of stay. The system's low-profile design and ability to maintain an extraperitoneal approach confer distinct benefits in patients with complex surgical histories or hostile abdomens. Although the SP platform incurs higher disposable instrument costs, overall expenditures are mitigated with decreased hospital length of stay and reduced postoperative care requirements. As surgical experience and technological refinements progress, the SP robotic platform is anticipated to achieve broader integration in benign urology. Overall, SP robotic surgery offers a safe, effective, and patient-centered alternative to established minimally invasive techniques with the potential to further optimize perioperative outcomes and redefine the standard of care in contemporary urologic practice.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"27 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective Mentorship in Urology Fellowship Training: Qualities, Models, and Equity.","authors":"Eric S Giannaris, Aaron M Brant, Joseph P Alukal","doi":"10.1007/s11934-026-01344-1","DOIUrl":"10.1007/s11934-026-01344-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>To review recent evidence on effective mentorship practices in urology fellowship training, with emphasis on mentorship qualities, structured programs, and equity considerations.</p><p><strong>Recent findings: </strong>While few studies have examined mentorship specifically within urology fellowship, available evidence suggests that effective mentorship is dynamic and characterized by accessibility, alignment with mentee goals, and reciprocal engagement. Access to formal mentorship may reduce burnout and improve trainee well-being. Structured surgical mentorship programs have been associated with shortened learning curves and successful surgical outcomes. Diversity-focused initiatives have demonstrated success in improving representation in urology, yet disparities in mentorship access remain for women and underrepresented groups. Mentorship in urology fellowship can improve trainee well-being, foster career development, and support equitable representation. Collaborative efforts across subspecialty societies to expand structured mentorship models and establish standardized evaluation may strengthen training outcomes and reduce disparities in mentorship access and quality.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"27 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Lower Urinary Tract Symptoms in Patients With Multiple Sclerosis.","authors":"Tal Cohen, Kelly Ieong, Justina Tam","doi":"10.1007/s11934-026-01339-y","DOIUrl":"10.1007/s11934-026-01339-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review critically evaluates recent literature from the past five years concerning the management of lower urinary tract symptoms (LUTS) in patients with multiple sclerosis (MS), highlighting advances in understanding disease mechanisms, diagnostic strategies, and therapeutic options.</p><p><strong>Recent findings: </strong>LUTS can affect up to 90% of MS patients and arise due to lesions within the brain or spinal cord. Emerging insights emphasize the complexity of symptom presentation and the limitations of symptom-based diagnosis alone, underscoring the importance of systematic evaluation and multidisciplinary approaches. Treatments include patient centered behavioral and pharmacological therapies, minimally invasive options such as botulinum toxin injections or neuromodulation, and surgical management. Effective management of LUTS in MS demands a multidisciplinary, patient-centered approach focused on renal function preservation and quality of life improvement. Future research should address disease-specific guidelines and personalized care strategies.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"27 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower Urinary Tract Symptoms as an Indicator of Occult Neurologic Disease: A System-first Framework for Urologic Practice.","authors":"Elizabeth Minnerath, Olga Khazen, Jalesh N Panicker, Marcus J Drake, Elise J B De","doi":"10.1007/s11934-026-01343-2","DOIUrl":"10.1007/s11934-026-01343-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Lower urinary tract symptoms (LUTS) may precede or accompany the other symptoms of neurologic disease and may be the presenting clinical manifestations of central, peripheral, or autonomic nervous system dysfunction. In clinical practice, urologists are often the first specialists to evaluate these patients, potentially before underlying neurologic disease has been identified. Early recognition of neurologic contributors to LUTS may help prevent diagnostic delay. This review aims to provide a symptom-based framework that highlights common urologic presentations associated with underlying neurologic disease, along with urodynamic findings of concern, to support earlier recognition of neurological disease in patients presenting with LUTS.</p><p><strong>Recent findings: </strong>Recent work has characterized neurologic diseases associated with LUT dysfunction using disease-based frameworks. Despite this, gaps persist in routine urologic evaluation, including inconsistent screening for neurological symptoms and limited incorporation of focused neurologic history and examination. Certain urodynamic patterns are increasingly recognized as suggestive of neurological pathology but are not consistently interpreted within this context. Barriers to timely neurologic evaluation, including limited specialist availability and prolonged wait times, further contribute to diagnostic delay. As a result, there is growing recognition of the need for urologists to identify clinical features within LUTS presentation that should prompt consideration of neurologic disease, though practical strategies for integrating these insights into routine care remain limited. A symptom-based framework for evaluating LUTS can enhance early detection of neurologic disease in urologic practice. Urologists and pelvic health specialists should have a broad understanding of what clinical characteristics associated with LUTS should trigger concern for underlying neurological disease and should always consider neurological disease in the differential diagnosis. This review provides a practical, clinically oriented overview of neurologic disease in LUTS assessment, including guidance on screening questions, initial testing considerations, urodynamic interpretation, and referral, particularly in the settings with limited neurology access. Algorithms are provided to facilitate early recognition of occult neurological disease within routine urologic practice.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"27 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13230311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148142964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}